Learn what you’ve got to stop doing that causes elbow pain and three distal biceps tendonitis exercises to heal this problem for good.
If you’ve got pain in your elbow where your biceps connects to the forearm at the front of your elbow, that might be distal biceps tendonitis.
The exercises here will address the root causes of distal biceps tendonitis. However, you still need to do the exercises and apply the concepts we taught in the previous article linked below.
Bicep Tendonitis: 4 Unique Exercises to Address the Root Cause
We decided to do this video and article because we were reading the comments on our original biceps tendonitis video where we discussed proximal biceps tendonitis, which is pain in the upper biceps, where it originates up near the shoulder.
If you want to follow along with a video of these exercises, check out 3 Exercises to Heal Distal Biceps Tendonitis Pain on YouTube. And, because it builds on our previous Biceps Tendonitis video, also check out the exercises from 4 Unique Exercises to Fix Biceps Tendonitis on YouTube.
What is Distal Biceps Tendonitis?
Distal biceps tendonitis is pain at the front of the elbow, right around where the biceps brachii muscle inserts into the forearm.
One of the top causes of distal biceps tendonitis is a muscle in the forearm called the supinator. Its primary function is (you guessed it) supination. Now the biceps brachii also supinates at the forearm and flexes the elbow.
Supination in turning the palm up toward the sky.
If the supinator is not working and it’s not contributing to that movement of supination, then the biceps brachii has to pick up the slack for the supinator. Then your poor biceps brachii gets overworked, which leads to inflammation, which leads to pain. That’s one possible root cause – the biceps brachii compensating for the inactive supinator.
Another one is with respect to elbow flexion. We have a couple of other muscles contributing to this elbow flexion movement – the arm curl movement. One is the brachialis, which is underneath the biceps. It sits deep to the biceps brachii. The other is the brachioradialis, which is in the forearm.
Now if either or both of these muscles aren’t working well, again, the biceps brachii will have to pick up the slack, getting overworked and painful.
Those are two potential root causes – both related to synergistic muscles in the arm not working properly.
The last one is tissue quality. You may have some adhesions in the biceps area. If you ever had other elbow injuries, there might be some scar tissue. Muscles sometimes can just get adhered to fascia. If the biceps tendon cannot glide, because it has stuck to adjacent tissues, then this can increase the force on the tendon leading to, you guessed it, wear and tear and tendonitis.
Those are the potential root causes of elbow biceps tendonitis that we will address with the three exercises in this article.
Now the other thing that you’ve got to remember is you might be doing something contributing to the wear and tear, whether it’s caused by exercises in the gym or just activities and movements of daily life. You’ve got to modify those for a period of time during that initial healing phase. That way, you can get that sensitivity down, and we can start to work these other muscles to get them strong enough to pick up the slack and get back to work.
Some of these stressors are exercises in the gym, like pull-ups and chin-ups. Really anything where you’re pulling rows and using the biceps.
Just pause those for a week, maybe two weeks at most. But then you can reintroduce them a little bit lower volume and just ramp it up from there.
Other exercises, like heavy carries, farmer’s walks, or any kind of deadlifting that you’re doing with one or both palms facing up (supinated) or the power grip, stop it. Exercises with both palms down should be okay. But anytime your palms are up, you’re going to be using that biceps in a position that can make it vulnerable.
Stop those exercises. Let your body heal for one or two weeks. While you’re letting it heal, and do the exercises that we will show you below.
Distal Biceps Tendonitis Exercises
The first technique we nearly always start off with improves tissue quality, which is one of the first steps to movement longevity. The next two exercises will strengthen the sleepy muscles in your arm that contribute (rather, their lack of contribution) develops into distal biceps pain.
Exercise 1: ASMR Biceps
Let’s start off with the first technique that will improve tissue quality. That’s active self-myofascial release for the biceps.
- Start with the elbow flexed
- From there, jam your thumb somewhere in between the biceps and the brachialis.
- Slowly extend the elbow as you slide your thumb up towards your shoulder.
- Start your thumb in a new spot, flexing your elbow
- Repeat in different areas all around the bicep
Do 1-2 minutes per arm.
We’re just going to move all around the biceps and get the whole tissue, whether there are adhesions, scar tissue, or muscle knots. Get those all released.
Switch to the other side of the biceps and go all around different areas. You can go out to the forearm up into crossing the elbow joint and then into the biceps. Just move it all around different areas for one to two minutes.
This is going to help improve the tissue quality so that the muscles can move through their full range of motion. They don’t get stuck.
Exercise 2: Forearm Supinator Activator
Next up, we’ve got the supinator activation. For this technique, you’ll need a band. You can use a strength band, bungee cord, or anything you can anchor on one side and grab the other with your hand that has a little stretch to it.
Put the band just about hand height when you’re hands are down by your sides.
- Start by grabbing the band with the palm down
- Supinate (rotate up) nice and slow while firing up the tricep to extend your elbow
- Hold at the end range for 5 seconds
- Slow return
For this exercise, do 2 to 3 sets of 4-6 reps, with 5-second holds.
Keep trying to get deeper into the end range, so keep supinating as you’re extending the elbow. Fire up your triceps to extend your elbow. That’s how we’re going to build strength.
Now the reason why we fire up the triceps is so that we can shut off the bicep through reciprocal inhibition. We activate the triceps and strengthen the elbow. We can shut off the bicep a little bit so that it’s not contributing to the supinator movement.
The other thing with this position is that when the elbow is fully straight, the biceps brachii doesn’t have a good mechanical advantage to supinate. Instead, the supinator has to do more of that work.
Start down low in the reps and the sets. Then you’ll work your way up over time.
Exercise 3: Brachialis Curls
The final exercise is one that I love. It’s called Brachialis Curls. This is basically the opposite of what a standard dumbbell bicep curl is. Grab either one or two dumbbells, it’s up to you. It would be wise to get the hang of the exercise by only doing one arm (dumbbell) at a time.
- Stand with good shoulder posture, start with your palms up, holding the dumbbell
- Curl the weight by flexing the elbow as you pronate. (Turn the palms down)
- Once you’re at the top, keep pronating and squeeze the brachialis, try to get more flexion
- Hold for 2 seconds
- Extend your elbow slowly, keeping your palms facing down
- At the bottom, turn the palms up
Do 2-4 sets, working 6-8 reps with 2-second holds at the top. Start low and progress up over time.
That’s going to get that supinator active again.
Turn the palms down as you curl, and at the top, keep turning the palms down. So pronating as you’re flexing and squeezing for 2 seconds. Slowly return, turning the palms down more and more as you go down.
You turn the palms down to shut off the biceps. As you get more practiced at the movement, you can do both arms at the same time.
You’ll want to do these exercises on an every-other-day basis. Alternate between these exercises and the exercises in the other biceps tendonitis article. Here’s the link again, in case you need it.
Do this for at least two weeks, and then you can start to drop it down a little bit. Maybe you’ll focus more on these exercises, continuing them three days a week or so for another two weeks. At which point, you should be able to start to resume your other normal activities.
Just remember that ramping it up is better than jumping back in where you left off. Don’t just pick up again where you left off in your bicep curls, for example.
Start slow. Progress up, and that’s how you’ll restore that foundation and make sure that you can continue to move freely and without pain.
We have some other articles that you might find helpful. You might find the article on Healing Golfer’s and Tennis Elbow useful.
You might also like the Top 3 Exercises to Activate Your Serratus Anterior article to keep that shoulder stable because the shoulder affects the elbow.
Finally, if you have a comprehensive step-by-step program that starts off with exercises accounting for your level of pain on a 1-10 scale, check out the Elbow Pain Solution. This program leaves so stone unturned to keep you moving freely and without pain.
Thanks again, and we’ll see you next time. Peace.
I did many physio sessions with my physio but it gave limited results. After doing the program, I have benefited as I had elbow extension and flexion rages restricted.” Deepak Ahuja, 45
I did many physio sessions with my physio but it gave limited results. After doing the program, I have benefited as I had elbow extension and flexion rages restricted.”
Deepak Ahuja, 45